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Editors: Hoyt, Nicole, Liza and Cory. Contact us at intheloop@mayo.edu.

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February 16, 2016

Getting to the Heart of Karla’s Unusual Fatigue

By In the Loop

Karla Manley shares the story of learning she had a congenital heart defect with Florida's Action News Jax.

Karla Manley spent the first 33 years of her life doing the kinds of things we all do every day. But the daily routine hit her harder than most. "Whenever I'd get home, I would just be exhausted," she tells us.

It wasn't until she went in for a sinus-related procedure at Mayo Clinic's Florida campus in 2003 that Karla, who works as a senior analyst/programmer for Mayo Clinic, discovered she'd been living with a congenital heart defect called congenitally corrected transposition of the great arteries. "They did my pre-op workup, and my EKG and chest X-ray came back abnormal," she says. "I was sent for more testing, and that's when they found the defect."

According to MayoClinic.org, congenitally corrected transposition of the great arteries occurs when the heart's atria and ventricles are essentially crisscrossed. In Karla's case, her right atrium was connected to her left ventricle, while her left atrium was connected to her right ventricle. Even though her arteries connected to the wrong ventricles, her blood was still allowed to flow in the right direction. The problem was that the blood wasn't fully oxygenated, which doctors said had been the root cause of Karla's unusual fatigue.

Initially, doctors thought Karla would need a heart transplant, which she tells Florida's Action News Jax "was a shock." But Karla never made it onto the transplant list. Instead, she says her doctors at Mayo — Naser Ammash, M.D., and Joseph Dearani, M.D. — told her there might be another option. "Because my heart is transposed, and I also had a hole in the bottom of my heart, they thought if they could replace my tricuspid valve and close the hole, it would help take a lot of pressure off of my heart and allow good blood to be pumped back into my body," Karla says.

However, the timing needed to be just right to avoid doing the surgery "too soon, or too late." For Karla, the right time came in May 2012. And she flew to Rochester for a corrective open-heart surgery procedure she says has given her a new lease on life. "I feel better than I ever have," she says. "Now, I can go and do things without getting so tired. I feel more normal."

It's the kind of life-changing result that doctors at Mayo Clinic can now offer to more patients like Karla thanks to "better medication," "earlier intervention" and "innovations in medicine" that no longer make transplantation the only option for people with congenital heart defects. "The biggest misconception is there is nothing to be done if you are born with a complex heart defect, which is absolutely false," Dr. Ammash tells Action News Jax.

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